3. Managers who have actually worked as nurses in the units they manage, or in a close approximation thereof. Currently, we have one—one—manager in our system who’s worked for more than a year on an acute-care unit. The rest of our managers either worked for a year, then went back and got MBAs or degrees in management, or came straight out of school with a double major in nursing and management and never worked the floors at all. The difference between a manager who knows what happens on the floor and one who doesn’t is too huge to go into here; let’s just say that until you’ve walked the walk, I’m not going to pay much attention when you talk the talk.